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Thursday, January 25, 2018

Breastfeeding Reduces Long-Term Risk for Diabetes

Here is yet another study showing that breastfeeding long-term decreases the risk for developing diabetes.

In this latest study, breastfeeding for a total of 12 months or more cut the risk for diabetes by about HALF.

That's a pretty significant decrease. It's not an absolute guarantee against diabetes, of course, but there is excellent evidence that breastfeeding strongly reduces the risk for diabetes or delays its presentation. This has obvious benefits for heart health.

This latest study just adds to the accumulating evidence of the importance of breastfeeding for a woman's long-term health. Pregnancy alters the metabolism significantly, increasing insulin resistance and blood sugar in order to divert more energy to the developing baby. This is good in the short term, but bad for the mother long term.

Biologically speaking, lactation was meant to "re-set" the mother's metabolism back to normal after pregnancy. When this doesn't happen, the mother's metabolism remains altered to some extent and more prone to health issues like diabetes and heart problems.

Sometimes breastfeeding doesn't work out, and that's okay. But new mothers should know that biologically, their bodies were meant to lactate, and the longer the better. Moms who do nurse should be encouraged to nurse as long as possible, and given every support to do so. Moms who don't nurse or who stop within a few weeks or months should be alerted to be even more proactive about avoiding/watching for diabetes.

...OBJECTIVE: To evaluate the association between lactation and progression to diabetes using biochemical testing both before and after pregnancy and accounting for prepregnancy cardiometabolic measures, gestational diabetes (GD), and lifestyle behaviors. DESIGN, SETTING, AND PARTICIPANTS: For this US multicenter, community-based 30-year prospective cohort study, there were 1238 women from the Coronary Artery Risk Development in Young Adults (CARDIA) study of young black and white women ages 18 to 30 years without diabetes at baseline (1985-1986) who had 1 or more live births after baseline, reported lactation duration, and were screened for diabetes up to 7 times during 30 years after baseline (1986-2016)...RESULTS: Overall 1238 women were included in this analysis (mean [SD] age, 24.2 [3.7] years; 615 black women). There were 182 incident diabetes cases during 27 598 person-years for an overall incidence rate of 6.6 cases per 1000 person-years (95% CI, 5.6-7.6); and rates for women with GD and without GD were 18.0 (95% CI, 13.3-22.8) and 5.1 (95% CI, 4.2-6.0), respectively (P for difference < .001). Lactation duration showed a strong, graded inverse association with diabetes incidence: adjusted RH [relative hazard] for more than 0 to 6 months, 0.75 (95% CI, 0.51-1.09); more than 6 months to less than 12 months, 0.52 (95% CI, 0.31-0.87), and 12 months or more 0.53 (0.29-0.98) vs none (0 days) (P for trend = .01). There was no evidence of effect modification by race, GD, or parity. CONCLUSIONS AND RELEVANCE:This study provides longitudinal biochemical evidence that lactation duration is independently associated with lower incidence of diabetes....

...Using information on parity, breastfeeding, and diabetes collected from 52,731 women recruited into a cohort study, we estimated the risk of type 2 diabetes using multivariate logistic regression... Among parous women, there was a 14% (95% CI 10-18%, P < 0.001) reduced likelihood of diabetes per year of breastfeeding... CONCLUSIONS: Compared with nulliparous women, childbearing women who do not breastfeed have about a 50% increased risk of type 2 diabetes in later life. Breastfeeding substantially reduces this excess risk.

...Prospective observational cohort study of 83,585 parous women in the Nurses' Health Study (NHS) and retrospective observational cohort study of 73,418 parous women in the Nurses' Health Study II (NHS II)...RESULTS: ...Among parous women, increasing duration of lactation was associated with a reduced risk of type 2 diabetes. For each additional year of lactation, women with a birth in the prior 15 years had a decrease in the risk of diabetes of 15% (95% confidence interval, 1%-27%) among NHS participants and of 14% (95% confidence interval, 7%-21%) among NHS II participants, controlling for current body mass index and other relevant risk factors for type 2 diabetes. CONCLUSIONS: Longer duration of breastfeeding was associated with reduced incidence of type 2 diabetes in 2 large US cohorts of women....

Researchers hypothesize that pregnancy and lactation are part of a continuum, with lactation meant to "reset" the adverse metabolic profile that develops as a part of normal pregnancy, and that when lactation does not occur, women maintain an elevated risk of cardio-metabolic diseases. Several large prospective and retrospective studies, mostly from the United States and other industrialized countries, have examined the associations between lactation and cardio-metabolic outcomes. Less evidence exists regarding an association of lactation with maternal postpartum weight status and dyslipidemia, whereas more evidence exists for an association with diabetes, hypertension, and subclinical and clinical cardiovascular disease.

We assessed the relation between duration of lactation and maternal incident myocardial infarction. STUDY DESIGN: This was a prospective cohort study of 89,326 parous women in the Nurses' Health Study. RESULTS:... Compared with parous women who had never breastfed, women who had breastfed for a lifetime total of 2 years or longer had 37% lower risk of coronary heart disease (95% confidence interval, 23-49%; P for trend < .001), adjusting for age, parity, and stillbirth history. With additional adjustment for early-adult adiposity, parental history, and lifestyle factors, women who had breastfed for a lifetime total of 2 years or longer had a 23% lower risk of coronary heart disease (95% confidence interval, 6-38%; P for trend = .02) than women who had never breastfed. CONCLUSION: In a large, prospective cohort, long duration of lactation was associated with a reduced risk of coronary heart disease.

...In a Norwegian population-based prospective cohort study, we studied the association of lifetime duration of lactation with cardiovascular mortality in 21,889 women aged 30 to 85 years who attended the second Nord-Trøndelag Health Survey (HUNT2) in 1995-1997. The cohort was followed for mortality through 2010 by a linkage with the Cause of Death Registry...RESULTS:...Parous women younger than 65 years who had never lactated had a higher cardiovascular mortality than the reference group of women who had lactated 24 months or more (HR 2.77, 95% confidence interval [CI]: 1.28, 5.99)...CONCLUSIONS: Excess cardiovascular mortality rates were observed among parous women younger than 65 years who had never lactated. These findings support the hypothesis that lactation may have long-term influences on maternal cardiovascular health.

I don't know but I doubt it. Breastfeeding studies rarely account for PCOS.

However, I'd also point out that many women with PCOS are able to breastfeed without issue despite the PCOS. We don't really have good, reliable figures for how many women with PCOS have major bfing issues but the best estimates I've seen are around 1 in 3. That's substantial. But still, then, 2 in 3 do not.

Because people of all sizes deserve compassionate, gentle, helpful care.

The Well-Rounded Mama Blog

Painting by Mary Cassat, 1844-1926. Image from Wikimedia Commons.

Blog Mission

I write about health for people of size, plus-size pregnancy and birth, pregnancy and childbirth in general, parenting, and Health At Every Size®.

It is time for frank discussion about how fat people are treated in healthcare and how care for this group can be improved. It is also time for some common-sense information, without scare tactics or judgment, about pregnancy in women of size.

About The Author

I am a childbirth educator, writer, and mother to four kids. I also write at www.plus-size-pregnancy.org, and can be emailed at kmom at plus-size-pregnancy dot org.

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This site is written by healthcare consumers for healthcare consumers. The information provided here is not intended as medical advice. Consult your personal healthcare providers when deciding how to use this information.